Duodenal atresia

The duodenal atresia is a congenital developmental disorder in which the lumen of the duodenum is not continuous. This is either due to a lack of intestinal share (a real atresia ), a membrane in the intestinal lumen or a malformation of the pancreas due to ( ring-shaped defects in the pancreatic Annular pancreas ) to give rather speaks in this case of a duodenal obstruction. The lack of consistency causes before the atresia expand greatly before the birth of the stomach and intestine share and the remaining intestine remains small, since the swallowed amniotic fluid does not reach this intestinal portion.

Frequency

The frequency of occurrence is 1:7.000. The duodenal atresia in Annular pancreas is found more frequently in children with trisomy 21

Symptoms

The babies vomit because the food can not happen. Other possible symptoms are bilious vomiting, sunken lower abdomen, clear (gastric juice ) vomiting or a bulging upper abdomen.

Diagnostics

When ultrasound ( prenatal as part of prenatal diagnosis ) a duodenal atresia falls through the so-called "double -bubble " phenomenon on: The stomach of the unborn child is filled with liquid ( first bubble / "Bubble" ) and the duodenum ( duodenum) has liquid on ( second bubble / "Bubble "). Juxtaposition lying shows due to its ultrasound image of a double - bubble (so-called " double-bubble ").,

The same phenomenon can be seen even after birth by an X-ray examination. Characterized in that the upper gastro-intestinal tract following the birth filled with air, an air bubble in the stomach, as well as in the duodenum. The rest of the intestinal tract is evacuated.

Therapy

The therapy is postnatal ( postnatal) as soon as it is operational. Until then, a feeding tube is introduced in order to allow the secretion (saliva, gastric juice, small intestine juice), which can not flow into the other small intestine, a discharge possibility outward. The operation shall be opened depending on the cause of the atresia of either the intestine and the membrane cut through the intestinal sections sewn together or if the size differences between upper and lower portion are too large, a temporary enterostomy created, which is then removed later. After the surgery, it may take longer time due to massive expansions of the duodenum and associated disorders passage until a complete food intake can be done through the mouth.